• 간호행정학회지
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• 제4권2호
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• pp.475-487
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• 1998

This is a study to search for the ethical basis for valid informed consent of organ donors. It is an admirable action that a person give his own body part or organ as a gift to another person. The organ for transplantation can be removed only when the donor consents voluntarily to donation. It is recently proposed as the need for organ transplantation is increased that organs can be harvested although the consent of deceased cannot be obtained. This may raise many moral issues because human beings all have an unalienable right to control their own bodies. The principle of autonomy is usually regarded as an ethical basis for informed consent. However, some people criticize that the principle of autonomy requires a person and his decision to be autonomous (but there are many patients who aren't autonomous due to their confusion or unconscious condition in a clinical situation). or this principle can foster indifference to patients needing help: thus respect for principles of care and beneficence is necessary. When we consider the complexity of making a decision about organ donation. the principle of autonomy should be replaced by the principle of respect for individual autonomy. as expressed by Childress (1990). This principle requires the care givers to respect the client's individual decisions. The elements of informed consent are threshold elements: competence to understand and decide. voluntariness in deciding: information elements: disclosure of material information. recommendation of a plan. understanding of disclosure and recommendation: and consent elements: decision in favor of a plan. authorization of the chosen plan. In cases of living donors. the elements of competence and voluntariness are more important than the others. So only an adult can give a recipient his own body part. but it should be forbidden to harvest from minors or protected adults (i.e. developmentally disabled person However. when organs are removed from a cadaver donor. we ought to respect the donor's decision. So we ought to try to seek donor cards or any documents expressing the donor's opinion about organ transplant. All health care givers ought to disclose donor information about organ transplantation clearly enough for the donor to understand it and to be able to weigh the harms and benefits. We are going to propose 'the subjective standard' as the ethical standard of disclosure. This standard will assure that patients have enough information to be able to decide autonomously from their own position. Care givers have to consider the method of disclosure because donors can be influenced by it positively or negatively, Establishment of the Hospital Committee is recommended. because medical professionals will have a chance to discuss the procedure of decision and the validity of harvesting a organ from a person.

• 대한피부과학회지
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• 제56권10호
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• pp.603-608
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• 2018

Background: It is well known that skin cancer and precancerous disease develop more frequently in patients undergoing solid organ transplantation than normal populations in the normal population in Western countries. However, to date, the clinical and demographic features of skin cancer and precancerous disease after solid organ transplantation are not established in Asian countries. We evaluated the clinical and demographic features of primary skin cancer and precancerous lesions after solid organ transplantation and compared these with the trends observed in Western countries. Methods: We retrospectively reviewed the medical records of patients who underwent kidney, liver, heart, and lung transplantation between January 1995 and April 2017 and who developed skin cancer or precancerous lesions after transplantation. The various lesions observed were squamous and basal cell carcinoma, malignant melanoma, Kaposi sarcoma, Bowen's disease, and actinic keratosis. Results: We identified 4604 patients who received organ transplant. The mean age of patients was 44.8 years (male, 64.6%; female, 35.4%), and the sum of the person-year of observation time was 31,024 person-years. The incidence rate per 100,000 person-years was 29.01 for squamous cell carcinoma, 19.34 for basal cell carcinoma, 6.45 for malignant melanoma 3.22 for Kaposi sarcoma, and 74.17 for Bowen's disease and actinic keratosis. The incidence rate per 100,000 person-years was the highest in patients undergoing heart transplantation (610.50), followed by those who underwent kidney transplantation (136.54) and liver transplantation (90.15). Koreans showed lower incidence rates than those observed in Westerners. Conclusion: The incidence of primary skin cancer and precancerous lesions after solid organ transplantation in Koreans was lower than that in Westerners. Squamous cell carcinoma was the most common skin cancer in patients undergoing solid organ transplantation and the incidence rate of skin cancer and precancerous lesions was the highest in patients undergoing heart transplantation.

• 의료법학
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• 제17권2호
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• pp.125-144
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• 2016

모든 형태의 임상시험은 시험 자체가 불확실하며, 리스크가 다양하므로 피험자를 보호하기 위한 제도가 완비되어 있어야 한다. 그럼에도 불구하고 현행 임상시험에 관한 법률은 약사법과 의료기기법에서 일정한 규정을 두고 있으나 이는 '의약행정'을 원활하게 수행하기 위한 법목적에 비추어 피험자 보호에는 일정한 한계가 있다. 더 나아가 미성년 피험자를 대상으로 하는 임상시험은 약사법 등에서 직접적인 규정을 두지 않고, '소아를 대상으로 하는 임상시험 평가 가이드라인'이나 '의약품임상시험관리기준' 등에서 일정 부분 규율하고 있으나 이는 법적 효력이 없는 권고사항이라는 점에서 일정한 한계가 있다. 미성년자 대상 임상시험에 대한 법흠결 문제는 인체침습의 정도 면에서 통상적인 의료행위의 경우보다 강한 장기이식법상의 미성년자 취급제도와 기타 외국법상의 미성년자 임상시험 제도를 검토함으로서 입법적 해결이 가능하다고 할 것이다. 그러나 근본적으로는 현행법 체계상 약사법, 의료기기법 기타 가이드라인을 중심으로 이루어지고 있는 임상시험 규율체계를 이른바 "피험자보호법"이라는 법률제정을 통해 해결하는 것이 바람직하다고 본다.

• Journal of Sport and Applied Science
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• 제4권2호
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• pp.1-9
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• 2020

Purpose: This study sought to investigate the critical features of Word of mouth (WOM) advertising and their impact on sport consumer behavior. Research design, data, and methodology: Target population of the study consisted of all sports consumer of the Federation of Special Patients and Organ Transplantation, Tehran (Iran), who had indirectly watched the World Organ Transplant Competition documentary at least once on others' advice. For this purpose, 360 sports consumers of the federation were purposefully selected and they were asked to complete the standard WOM advertising questionnaire of Asda and Ko. Pearson correlation coefficient test and modeling of structural equations were performed using Spss24 and Smart PLS software at an error level of 0.05 used to analyze the data. Results: The findings show that there is a significant relationship between experience and expertise, trust and validity, content richness, and the power of message transmission through WOM advertising and its predictability. Finally, interpersonal relationships and work involvement also had a moderating role in this regard. Conclusions: The general conclusion is that the components of WOM advertising as well as involvement and homophily with the mediating role directly as one of the presuppositions for persuasion. The sports consumer was promoting WOM.

• 한국임상보건과학회지
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• 제3권1호
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• pp.299-310
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• 2015

Purpose. The purpose of this study was to investigate level of knowledge and attitude about organ donation in university and provide basic information on correct education and promotion. Method. The sample is consisted of 90 the students related to health and 90 general college students ; total 180 students in J city. The questionnaires were used to obtain the results. Data was collected from November 6th to 8th, 2013. For data analysis, the SPSS for window 12.0 K program was utilized to get descriptive statistics including the percentage, average, standard deviation and t-test. Results. Comparing the results between a series of health students and general college students, a series of health students showed high level of more knowledge and more positive attitude about organ donation than general college students. A series of health showed significant correlation but general college didn't show significant correlation. Conclusion. To educate correct knowledge draw positive attitude about organ donation is needed to improve the level of Knowledge and Attitude about organ donation.

• Korean Circulation Journal
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• 제54권6호
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• pp.325-335
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• 2024

Background and Objectives: The number of sensitized heart failure patients on waiting lists for heart transplantation (HTx) is increasing. Using the Korean Organ Transplantation Registry (KOTRY), a nationwide multicenter database, we investigated the prevalence and clinical impact of calculated panel-reactive antibody (cPRA) in patients undergoing HTx. Methods: We retrospectively reviewed 813 patients who underwent HTx between 2014 and 2021. Patients were grouped according to peak PRA level as group A: patients with cPRA ≤10% (n= 492); group B: patients with cPRA >10%, <50% (n=160); group C patients with cPRA ≥50% (n=161). Post-HTx outcomes were freedom from antibody-mediated rejection (AMR), acute cellular rejection, coronary allograft vasculopathy, and all-cause mortality. Results: The median follow-up duration was 44 (19-72) months. Female sex, re-transplantation, and pre-HTx renal replacement therapy were independently associated with an increased risk of sensitization (cPRA ≥50%). Group C patients were more likely to have longer hospital stays and to use anti-thymocyte globulin as an induction agent compared to groups A and B. Significantly more patients in group C had positive flow cytometric crossmatch and had a higher incidence of preformed donor-specific antibody (DSA) compared to groups A and B. During follow-up, group C had a significantly higher rate of AMR, but the overall survival rate was comparable to that of groups A and B. In a subgroup analysis of group C, post-transplant survival was comparable despite higher preformed DSA in a desensitized group compared to the non-desensitized group. Conclusions: Patients with cPRA ≥50% had significantly higher incidence of preformed DSA and lower freedom from AMR, but post-HTx survival rates were similar to those with cPRA <50%. Our findings suggest that sensitized patients can attain comparable post-transplant survival to non-sensitized patients when treated with optimal desensitization treatment and therapeutic intervention.

• Journal of Chest Surgery
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• 제38권9호
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• pp.656-659
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• 2005

뮤코르진균증은 비교적 드문 질환으로 면역이 저하된 환자에게 있어서 치명적인 기회감염을 일으킨다. 감염은 주로 혈액암, 만성 신부전, 당뇨 환자나 장기이식을 받은 환자에게 일어난다. 저자들은 조절되지 않은 당뇨를 동반한 신장이식을 받은 환자에서 발생한 폐뮤코르진균증을 암포테리신과 함께 수술적 절제를 통해 성공적으로 치료하였다.

• Transactions on Electrical and Electronic Materials
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• 제16권1호
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• pp.25-28
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• 2015

In this study, a basic research on artificial liver was performed for its application to people on the waiting list of liver transplant or patients with hepatic insufficiency. Artificial livers are generally classified into mechanic type, bioartificial type, and hybrid type. An extracorporeal circulation device was examined herein, which is indispensable in the application of an artificial liver, for its effectiveness in supporting the recovery of liver functions. Extracorporeal circulation system is a treatment and life-support system which sends out the patient's blood, removes toxicity by various methods, and then sends the blood back to the interior of the body. This study used an extracorporeal circulation system which enables the Plasma Perfusion by CVVH method, and applied the program of Bioateco corp. Animals with acute hepatic insufficiency were produced to apply the extracorporeal circulation device. As a result, their ammonia, bilirubin, SGOT, SGPT, and bile acid levels rose, confirming the liver function restoration in the experimental animals.

• Journal of Korean Dental Science
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• 제16권1호
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• pp.1-8
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• 2023

Dental treatment for the disabled should be a customized that considers the characteristics and degree of cooperation of each disabled patient. There are additional considerations during implant treatment and tooth extraction in disabled patients. Since some brain lesion disorder or cardiac disease patients may be taking antiplatelet or anticoagulant medications, it is necessary to evaluate whether these medications should be discontinued before an invasive procedure. Precautions should be taken for patients with heart valve disease considering the risk of infective endocarditis, especially during invasive dental procedures. Moreover, disabled patients may have difficulty in following instructions and cautions. There are specific considerations for each stage of implant treatment in disabled patients. In the case of patients who are in the pre- or post-transplant state, it is necessary to assess their general condition and oral disease due to the risk of infection. Since disabled patients with various systemic diseases may visit the dental clinic, it is important to understand their characteristics and treatment process in order to flexibly adjust the dental treatment plan accordingly.

• Journal of Chest Surgery
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• 제57권2호
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• pp.217-219
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• 2024

Matching for the rhesus (Rh) blood group is currently not taken into account in the organ allocation system. However, in Rh-mismatched transplantation, the primary concern is the potential for RhD-negative recipients to develop sensitization and produce anti-D antibodies if they receive a transfusion of RhD-positive blood. It is estimated that over 80% of RhD-negative recipients may experience Rh allosensitization when exposed to RhD-positive blood, although this occurrence is less common in recipients of solid organs. In theory, RhD-negative recipients who receive organs from RhD-positive donors are at risk of alloimmunization and the production of anti-D antibodies, which could complicate future blood product transfusions. However, our understanding of the impact of donor-recipient Rh mismatch on transplant outcomes, particularly in heart transplantation, is limited. We report a case of successful Rh-mismatched heart transplantation, which was effectively managed through the use of preoperative RhD immunoglobulin and plasmapheresis.